In 1984, the Asthma and Allergy Foundation of America (AAFA) declared the month of May to be “National Asthma and Allergy Awareness Month.” They chose this time of year because it represents the peak season for 65 million Americans who live with asthma or some form of allergies. Naturally, we think of asthma and allergies as respiratory issues, but they can impact a person’s oral health and how they receive treatment from a dentist.
The Oral Health Risks of Asthma and Allergies
As the AAFA noted, more than 65 million Americans overall have asthma and allergies. Some people may have one or both of these conditions.
- About 25 million Americans have asthma (20 million adults and 5 million children)
- About 32 million Americans have food allergies (26 million adults and 6 million children)
- About 24 million Americans have rhinitis (hay fever), or nasal allergies (19.2 million adults and 5.2 million children)
- There is no cure for asthma or allergies.
“These numbers paint a picture of how many people in the U.S. are managing asthma and allergies,” the AAFA said. “But they don’t paint a picture of the overall impact these diseases have on people, their caregivers, and communities.”
The statistics also fail to portray the risks of dental disease that asthma and allergy sufferers face.
- Increased risk of caries and enamel defects
- Heightened risk of gingivitis and periodontal disease
- Higher rates of malocclusion and overjet, overbite, posterior crossbite, and high palatal vault
- Oral candidiasis, xerostomia, and decreased salivary flow
Research around the world has shown a correlation between these respiratory ailments and greater risks of dental problems. A Swedish study of children and young adults with similar backgrounds and habits assessed the links between asthma and caries. Within the asthma group, 19 out of 20 subjects developed tooth decay. In the group of asthma-free subjects, 7 out of 20 developed tooth decay. So, 95% of those children and young adults with asthma demonstrated substantially higher risks for caries as opposed to the 35% of asthma-free people.
In a Korean study, poor oral health was “significantly correlated with the prevalence of asthma/allergic rhinitis/atopic dermatitis throughout life in Korean adolescents. Based on our comparative data, oral health-related education may be considered to adolescents with allergic disease for good oral health.”
Why Do Asthma and Allergies Increase Dental Risks?
Two of the primary oral health risk factors associated with asthma and allergies are related to breathing and medications. People with asthma, for example, may breathe through their mouths due to nasal allergies and tightened airways. Mouth breathing often leads to dry mouth, which in turn increases the chances of calculus, caries, oral candidiasis, enamel defects, gingivitis, periodontal disease, and even TMJ.
Some asthma medications reduce saliva and salivary enzymes in the mouth. The decreased flow of saliva also contributes to dry mouth and other health problems such as “oral thrush,” a type of yeast infection.
Risks Associated with Dental Treatment
It’s important to understand that people with allergies may require a different approach to dental treatment. Some of the equipment and materials used by dentists or hygienists may trigger allergic reactions in patients. They include:
- Prophy paste
- Rubber dams
- Tooth enamel dust
- Acrylic liquid
- Acrylic dust
Best Practices for Patients
At the Dental Office
Prior to undergoing any treatment or procedure, make sure that you list any known asthma symptoms or allergy triggers on the medical history form you receive from the dental team so that they can earmark those items on the dental charts. On the day of treatment, take the following actions:
- inform the dental staff of any allergies related to latex or other materials;
- bring your quick-relief inhaler, with spacer (if needed);
- provide the dentist with a list of all medications, including those contained in the daily control inhalers; and
- bring your EpiPen if prescribed.
Remember to work together as a team with your dentist and ask questions to ensure that your provider understands how to treat patients with allergies or asthma. For instance, if you’re allergic to aspirin, the dentist should not recommend aspirin, other salicylates, and NSAIDS like ibuprofen as they can provoke an asthma attack in some patients. Your dentist should know this and recommend acetaminophen instead.
There are preventative steps that people with allergies and asthma can take each day to reduce their risks of oral health complications.
- Ask your medical health provider for an asthma action plan to help guide self-management efforts.
- Hydration is key. Always rinse your mouth with water after using a corticosteroid inhalant and do not swallow the water; swish it around your teeth, then spit it out.
- Consider chewing gum with xylitol sweetener, not sugar, to help keep your mouth moist between meals. It also reduces bacteria in the mouth, which contributes to cavities.
- Use a spacer with your inhaler. This allows the medication to enter the lungs directly and more effectively, rather than lingering in your mouth.
- Dutifully follow daily oral hygiene practices: brush at least twice a day, floss at least once a day, and visit your dentist every 6 months.
Asthma and allergies have no cure. But oral health problems do. And better yet, they can be prevented with vigilance, attention, and routine care. If you haven’t seen a dentist in a while, schedule an appointment.